Symptoms, Electrolyte Disturbances and Serum Albumin Levels in Palliative Oncology Patients Admitted Through Emergency: Characteristics and Survival Outcomes.

Objectives: Our research aimed to examine the characteristics of palliative oncology patients hospitalised through an emergency to look for the symptom profile, characteristics of dyselectrolytemia and blood investigations, and possible associations with mortality. Materials and Methods: After institutional review board approval, a retrospective, observational study of patients hospitalised in our tertiary care specialty oncology hospital was undertaken. Records of hospitalised cancer patients admitted from the emergency department under palliative care from January 2019 to October 2021 were examined. As all admissions during this period were through emergency due to institution COVID-19 protocols, all elective admissions were excluded from the study. Data collected included patient characteristics, blood investigations, and comorbid history of systemic diseases and factors that could be associated with electrolyte imbalance. Results: There were 157 emergency admissions during the study period. A majority were patients with solid tumours (92.4%). Pain was the most frequent cardinal symptom, along with other symptoms (68/157) or in isolation (33/157), followed by reduced oral intake (32/157) and altered sensorium (24/157). sixty-six patients died within the hospitalisation period. On long-term follow-up, only 8 (5.1%) were surviving. Hyponatraemia (43%), Hypoalbuminaemia (66%), and altered renal function (33.1%) were prevalent. We observed a weak positive correlation between sodium levels and outcome (r = 0.199, P = 0.016) and a strong positive correlation between albumin levels and survival outcomes (r = 0.329, P = 0.000). Patients with normal albumin had a higher chance of survival (odds ratio: 33.1225, 95% confidence interval: 3.415-321.20, P = 0.003). Conclusion: Pain-reduced oral intake and altered sensorium are common emergency symptoms in oncology palliative care. Mortality is high in these patients. Hyponatraemia, hypoalbuminaemia, and deranged renal functions were commonly seen. Normal sodium and albumin levels were associated with higher chances of survival, and the association was strong for serum albumin levels. This may have prognostic utility.

Assessing the modifiable and non-modifiable risk factors associated with multimorbidity in reproductive aged women in India.

BACKGROUND: Reproductive span is the foundation of every woman's health in later life. India is currently facing a growing burden of multiple morbidities among the women in their reproductive age group which may further increase over the coming decades. The purpose of the present study aimed to identify different modifiable and non-modifiable risk factors affecting multimorbidity among the women in reproductive age group in Indian context. METHODS: Secondary data were obtained from the Demography and Health Survey (DHS), conducted in India during 2019-2021. A total of 671,967 women aged 15-49 years were selected for this present study. Descriptive, association studies and multinominal logistic regression analyses were performed to accomplish the objectives. RESULTS: Currently, 6.3% of total study participant's reproductive age group women suffered from multimorbidity in India. Never consuming protein, fruits, vegetables and milk increase the chances of developing multimorbidity. Consumption of fried foods, aerated drinks and addiction towards tobacco and alcohol also has a greater influence on the prevalence of multimorbidity. The prevalence of multimorbidity is sharply increased with increasing age and Body Mass Index (BMI). Regionally, the prevalence of multimorbidity was found more among the women hailed from eastern and north-eastern India. CONCLUSION: To reduce the risk of developing multimorbidity, targeted interventions are needed in the form of educating every woman concerning the importance of having minimum health-related knowledge, maintaining healthy lifestyle, weight management and having proper and balanced diet.

Dual Glyoxalase-1 and ß-Klotho Gene-Activated Scaffold Reduces Methylglyoxal and Reprograms Diabetic Adipose-Derived Stem Cells: Prospects in Improved Wound Healing.

Tissue engineering approaches aim to provide biocompatible scaffold supports that allow healing to progress often in healthy tissue. In diabetic foot ulcers (DFUs), hyperglycemia impedes ulcer regeneration, due to complications involving accumulations of cellular methylglyoxal (MG), a key component of oxidated stress and premature cellular aging which further limits repair. In this study, we aim to reduce MG using a collagen-chondroitin sulfate gene-activated scaffold (GAS) containing the glyoxalase-1 gene (GLO-1) to scavenge MG and anti-fibrotic ß-klotho to restore stem cell activity in diabetic adipose-derived stem cells (dADSCs). dADSCs were cultured on dual GAS constructs for 21 days in high-glucose media in vitro. Our results show that dADSCs cultured on dual GAS significantly reduced MG accumulation (-84%; p < 0.05) compared to the gene-free controls. Similar reductions in profibrotic proteins α-smooth muscle actin (-65%) and fibronectin (-76%; p < 0.05) were identified in dual GAS groups. Similar findings were observed in the expression of pro-scarring structural proteins collagen I (-62%), collagen IV (-70%) and collagen VII (-86%). A non-significant decrease in the expression of basement membrane protein E-cadherin (-59%) was noted; however, the dual GAS showed a significant increase in the expression of laminin (+300%). We conclude that dual GAS-containing Glo-1 and ß-klotho had a synergistic MG detoxification and anti-fibrotic role in dADSC's. This may be beneficial to provide better wound healing in DFUs by controlling the diabetic environment and rejuvenating the diabetic stem cells towards improved wound healing.

Formulation of silver nanoparticles using Duabanga grandiflora leaf extract and evaluation of their versatile therapeutic applications.

The current research focused on the green synthesis of silver nanoparticles (AgNPs) using Duabanga grandiflora leaf extract. The green synthesis of AgNPs was confirmed by the surface plasmon resonance band at 453 nm in a UV-Visible analysis. The formulated AgNPs had a diameter of around 99.72 nm with a spherical shape. Fourier transform infrared (FTIR) spectrum revealed the bio-reducing potential of phytochemicals present in D. grandiflora, which fundamentally influenced the synthesis of AgNPs. Zeta potential, dynamic light scattering (DLS), scanning electron microscopic (SEM), energy-dispersive X-ray spectroscopic (EDX), X-ray diffraction (XRD), and transmission electron microscopic (TEM) analyses were executed to reveal the physicochemical attributes of the AgNPs. The AgNPs were further investigated for their antioxidant, antidiabetic, anticancer, and antibacterial potential. The DPPH free radical assay revealed the potential radical scavenging capacity (IC50 = 76.73 µg/ml) of green synthesized AgNPs. α-Amylase inhibitory assay displayed significant inhibitory potential (IC50 = 162.11 µg/ml) of this starch-breaking enzyme by AgNPs, revealing the antidiabetic potential of AgNPs. AgNPs exhibited potential cytotoxic activity (IC50 = 244.57 µg/ml) against malignant human kidney cells. In addition, AgNPs showed outstanding antibacterial activity against both Gram-negative (Escherichia coli) and Gram-positive (Staphylococcus aureus) bacterial strains. Interestingly, AgNPs showed cytotoxic and antimicrobial activities at much higher concentrations than radical scavenging and α-amylase inhibitory concentrations. Thus, our finding elaborated the scope of green synthesized AgNPs for diverse therapeutic applications (dose-dependent) for further clinical translation.

An association of deficiencies in balanced dietary practices and inadequate iron and folic acid supplement's intake during pregnancy and increasing risk of pre-eclampsia or eclampsia among Indian women.

Pre-eclampsia or eclampsia is a serious reproductive health problem which can cause maternal, fetal and neonatal morbidity and mortality worldwide. However till the notable reasons of it is not very clear at all. The main essence of the present study was to examine the association between dietary intake, iron and folic acid consumption during pregnancy and the chances of occurrences of pre-eclampsia or eclampsia among Indian women. A cross sectional observational study was performed by using NFHS-5 (2019-21) data. 190,797 ever married women aged between 15-49 years who had a live birth in the past five years preceding the survey were availed for this study. Multivariable logistic regression analysis was carried out to find out the association between dietary and supplementary intake and occurrences of eclampsia. About 3.6% of the sample women had pre-eclampsia or eclampsia. The results of the study indicated that the likelihood of the prevalence of pre-eclampsia or eclampsia was significantly higher among those women who did not take adequate diet and as well as not consumed iron and folic acid tablet or syrup for at least 90 days during pregnancy compared to those women who took adequate diet and iron and folic acid supplementation even after controlling some maternal, health and lifestyle, socio-economic and demographic characteristics. Integrated and quality ANC services can only ensure adequate nutritional intake in terms of healthy and balanced diet. So, quality ANC services and with this micronutrients intake could be an effective way to reduce the prevalence of pre-eclampsia or eclampsia.

Papaya peel extract-mediated green synthesis of zinc oxide nanoparticles and determination of their antioxidant, antibacterial, and photocatalytic properties.

This study describes an effective and eco-friendly approach to the synthesis of zinc oxide nanoparticles (ZnONPs) utilizing papaya fruit peel extract (PPE). The structural evaluation and morphological features of synthesized ZnONPs were examined using various physicochemical analyses. The formulated ZnONPs were spherical to hexagonal in shape with ⁓ 170 nm in diameter. ZnONPs exhibited improved antioxidant potential in terms of DPPH radical scavenging activity (IC50 = 98.74 µg/ml) and ferric-reducing potential compared with PPE. The antibacterial activity of ZnONPs was measured against pathogenic strains of Salmonella typhi, Bacillus subtilis, Staphylococcus aureus, and Escherichia coli. The biosynthesized ZnONPs showed potential antibacterial efficacy against all microbes. In addition, ZnONPs exhibited potential photocatalytic activity in rhodamine B degradation in the presence of sunlight. The results indicated that papaya peels, which are these fruit wastes, could be helpful for the green synthesis of ZnONPs with good dose-responsive antioxidant, antibacterial, and photocatalytic activities.

Liver abscess with extension into the Inferior Vena Cava: Case series of a rare complication.

Liver abscess is a common disease, however, it is a rare cause of venous thrombosis. The incidence of amoebic and pyogenic liver abscess in developing countries is high, however, the occurrence of inferior vena cava thrombosis secondary to liver abscess is a very rare and life-threatening complication. Computed tomography (CT) scan is an ideal investigation tool for diagnosing the various complications associated with liver abscess. Here we describe 3 cases of liver abscess in patients who developed a rare vascular complication of inferior vena cava. Liver abscesses should be considered as a rare cause of IVC thrombosis in the correct clinical context. All the patients were managed with ultrasound-guided pigtail insertion and antimicrobial agents.

A nitrogen-rich two dimensional covalent organic framework with multiple carbonyls as a highly efficient anchoring material for lithium-sulfur batteries.

Lithium-sulfur (Li-S) batteries, as next generation energy storage systems, have gained considerable attention due to their high energy density, low cost, and environmental friendliness. However, the practical applications of Li-S batteries are presently hindered by several issues, such as the low conductivity of sulfur species, the shuttle effect of polysulfides, and poor conversion efficiency in discharging/charging processes. In this study, using density functional theory (DFT)-based computations, we propose a two dimensional (2D) covalent organic framework (COF) with triquinoxalinylene (TQ) and benzoquinone (BQ) units in its skeleton, namely, TQBQCOF, as a promising sulfur host material for high-performance Li-S batteries. We have found that the TQBQCOF is a semiconductor with a band gap of 1.16 eV. After the adsorption of LiPSs the TQBQCOF becomes metallic in nature, which ensures its excellent electronic conductivity. The moderate adsorption energies of the TQBQCOF to the soluble LiPSs can effectively suppress the shuttle effect of polysulfides. Notably, the TQBQCOF also shows high catalytic activity for the sulfur reduction reactions (SRR) in the discharge process and Li2S decomposition in the charging process of Li-S batteries. The Gibbs free energy barrier for the SRR is 0.22 eV, while the decomposition barrier of a Li2S molecule on the TQBQCOF is only 0.04 eV, ensuring the rapid charging and discharging processes of Li-S batteries.

Surfactant-mediated enhanced FRET from a quantum-dot complex for ratiometric sensing of food colorants.

Herein we report that a surfactant modified quantum dot-complex (S-QDC; with λem-515 nm) nanocomposite, as a donor fluorophore, exhibits enhanced Förster resonance energy transfer (FRET) efficiency to an acceptor organic dye (λem-576 nm) in comparison to only the QDC. The proposed S-QDC (consisting of a ZnS quantum dot, zinc quinolate inorganic complex and cetyltrimethylammonium bromide (CTAB) surfactant) provides the unique and selective ratiometric visual detection of organic dyes present as food colorants in commercial chili powder, tomato ketchup and mixed fruit jam. Notably, the S-QDC shows a limit of detection (LOD) as low as 2.2 nM in the linear range of 0.17-4.89 µM for food colorants. Furthermore, the present work will bring new possibilities to unravelling the chemistry among surfactants, inorganic complexes and quantum dots to make newer optical materials with futuristic scope of utilization ranging from optical sensors to light emitting devices.

Preparation of silver nanoparticles by Osbeckia stellata aqueous extract via green synthesis approach: Characterization and assessment of their antioxidant, antidiabetic, cytotoxicity, and antibacterial properties.

Silver nanoparticles (Ag NPs) via green synthesis using medicinal plants have been widely used in natural product research due to the economical and eco-friendly properties of NPs. The plant-derived Ag NPs biosynthesis comprises the interaction between silver nitrate (precursor) and bioactive components of plant extract (reducing agents). In this work, Ag NPs were biosynthesized using Osbeckia stellata leaves aqueous extract. Characterization of Ag NPs was done by using ultraviolet-visible absorption (UV-Vis) spectroscopy, dynamic light scattering (DLS), Fourier transform infrared spectroscopy (FTIR), X-ray powder diffraction (XRD), scanning electron microscopy (SEM), transmission electron microscopy (TEM), and energy-dispersive X-ray analysis (EDX). Further, antioxidant, antidiabetic, cytotoxicity, and antimicrobial activities were evaluated to establish the pharmacological properties of Ag NPs. UV-Vis spectroscopy and FTIR showed an absorption peak of Ag NPs due to the surface plasmonic resonance. In contrast, the particle size in the nanometer range was analyzed by XRD and DLS. The size of the particle was confirmed by the SEM, TEM, and EDX in the nanometer range. This study showed the spherical shape and crystalline nature of NPs. Zeta potential was used to determine the stability of Ag NPs. Biosynthesized Ag NPs showed significantly potent antioxidant, antidiabetic, and cytotoxicity activity. Ag NPs also showed effectiveness against gram-positive (Escherichia coli) and gram-negative (Staphylococcus aureus) bacteria in the antimicrobial activity study. The result concluded that these Ag NPs might be used in biomedical and pharmacological fields.

Evaluation of maceration, microwave, ultrasound-assisted extraction methods on free, esterified and bound phenolic profile and antioxidant activity of black rice.

Black rice (Oryza sativa L.) is a rich source of phenolics and anthocyanins. It was aimed to investigate the effect of different extraction methods such as conventional solvent extraction, ultrasound-assisted extraction (UAE), and microwave-assisted extraction (MAE) on antioxidant activity and phenolic profiling of black rice free, esterified, and bound phenolics fractions. Spectrophotometric methods were used to evaluate antioxidant activity and HPTLC was used for phenolics profiling. The highest content of % yield, total anthocyanin (TAC), total phenolic (TPC), and total flavonoid (TFC) contents were detected in MAE. It was also observed that antioxidant activity based on DPPH, ABTS, superoxide radical-scavenging and ferric reducing antioxidant power (FRAP) assays showed highest activity in MAE. Eight phenolic compounds were identified and quantified by a validated HPTLC method. MAE showed most abundant phenolic compounds. A significant positive correlation was established between % yield, total phenolic content, and total flavonoid content (p < 0.05) where a significant negative correlation was established between % yield, TPC, and TFC with IC50 of antioxidant activity (p < 0.05). Diverse phenolic contents and antioxidant activity were studied with different forms of phenolics with the different extraction methods. It designates that the extraction techniques had effects on the bioactive compounds as well biological properties.

Impact of ultrasound-assisted extraction of polyphenols and caffeine from green tea leaves using high-performance thin-layer chromatography.

Tea is the most popular daily drink consumed globally, with a high concentration of caffeine and polyphenols. In this study, the effects of ultrasonic-assisted extraction and quantification of caffeine and polyphenols from green tea were investigated and optimized using 23 -full factorial design and high-performance thin-layer chromatography. Three parameters were optimized to maximize the concentration of caffeine and polyphenols extracted using ultrasound: crude drug-to-solvent ratio (1:10-1:5), temperature (20-40°C), and ultrasonication time (10-30 min). The optimal conditions achieved from the model for tea extraction were as follows: crude drug-to-solvent ratio, 0.199 g/ml; temperature, 39.9°C; and time, 29.9 min; the extractive value was found to be 16.8%. Images from scanning electron microscopy showed that the matrix underwent a physical alteration and cell wall disintegration, which intensified and accelerated the extraction. This process might be simplified using sonication, which results in a higher extractive yield and a significant concentration of caffeine and polyphenols than the traditional approach, with a smaller quantity of solvent and faster analytical times. The result of high-performance thin-layer chromatography analysis proves a significant positive correlation between extractive value and caffeine and polyphenol concentrations.

Molecular insights into hereditary elliptocytosis and pyropoikilocytosis: NGS uncovers multiple potential candidate genes.

Hereditary elliptocytosis (HE) and pyropoikilocytosis (HPP) are considered a group of hemolytic anemias (HE/HPP) due to inherited abnormalities of erythrocyte membrane proteins with a worldwide distribution. Most cases are associated with molecular abnormalities linked to spectrin, band 4.1, and ankyrin. The present study aimed to identify significant molecular signatures on a target panel of 8 genes using whole exome sequencing (WES) in 9 Bahraini patients with elliptocytosis. Case selection was based on presence of anemia not associated with iron deficiency or hemoglobinopathy and demonstrating > 50% elliptocytes in blood smears. The c.779 T > C mutation of SPTA1 (Spectrin alpha), which is a known deleterious missense mutation that inhibits normal association of spectrin molecules to form tetramers, was seen in 4 patients in homozygous (n = 1) and heterozygous (n = 3) states. The αLELY abnormality in association with compound heterozygous mutations in SPTA1 was present in 5 patients (2 associated with the SPTA1 c.779 T > C variant; 3 with c.3487 T > G and various other SPTA1 mutations of uncertain/unknown significance). Seven patients had SPTB (Spectrin beta) mutations, predicted as likely benign by in silico analysis. A novel EPB41 (Erythrocyte Membrane Protein Band 4.1) mutation with potential deleterious impact was also seen. Finally, 2 cases showed an InDel (insertion-deletion mutations) abnormality in the gene that codes for the mechanosensitive ion-channel PIEZO (Piezo Type Mechanosensitive Ion Channel Component 1). PIEZO mutations are reported to cause red cell dehydration but have not been previously described in HE/HPP. Results of this study confirm the involvement of previously reported abnormalities in SPTA1 and suggest possible involvement of other candidate genes in a disorder involving polygenic interactions.

Risk Factors, Incidence, and Outcome of Stroke: A Retrospective Cross-Sectional Hospital-Based Study Comparing Young Adults and Elderly.

A noticeable increase of up to 40% in the incidence of stroke among young population over the past decade has been noted. This study aimed to investigate the incidence, risk factors, and outcomes of stroke and its subtypes in young adults compared to older population. A retrospective study of patients which included patients with confirmed diagnosis of stroke based on the International Classification of Diseases 10th Revision (ICD-10) classification between the years 2018 and 2020 was conducted. The results indicated that patients less than 45 years of age had a higher incidence of hemorrhagic stroke as compared to the other age groups (p=0.011). Hypertension leading to hemorrhagic stroke was higher in patients less than 45 years of age as compared to other groups (18 years {19.4%} versus 33 years {7.5%}, p=0.001). Hypertension was noted to be the leading risk factor for stroke among the younger population.

Analyzing determinants from both compositional and contextual level impeding desired linear growth of children in Indian context.

Childhood stunting is recognized as significant public health concern in India. It is a form of malnutrition with impaired linear growth and creates a range of adversaries among children, including under-5 mortality, morbidity, and physical and cognitive growth. The purpose of the present study was to recognize the various leading determinants causing childhood stunting from both individual and contextual level in Indian context. Data were obtained from the India's Demography and Health Survey (DHS) conducted in 2019-2021. A total of 1, 46,521 children aged 0-59 months were included in this present study. The study applied a multilevel mixed-effect logistic regression model in which individual factors nested within community based contextual-level factors estimating the likelihood of childhood stunting phenomena among Indian children. The variance explained in full model accounted for about 35.8% of the odds of stunting across the communities. The present study elucidates that the recognized factors from individual level characteristics have really increased the odds of childhood stunting: gender of child, multiple births, low birth weight, low BMI among mothers, less educational attainment by mothers, maternal anemic status, breast feeding duration longer than usual, < 4 antenatal care (ANC) visits during gestation period. Similarly, contextual-level factors like rural places of residence, western Indian children, and communities with high poverty rates, lower literacy rates, improper sanitation, and unsafe drinking water were also found to have a significant positive association with childhood stunting. The study finally concludes that cross level interaction between individual and contextual-level factors are identified as significant determinants of linear growth retardation among child in India. In order to reduce this type of malnutrition among the child one should more concentrate on both individual and contextual-level factors as a notable reasons.

Community health workers and Covid-19: Cross-country evidence on their roles, experiences, challenges and adaptive strategies.

Community health workers (CHWs) are a key part of the health workforce, with particular importance for reaching the most marginalised. CHWs' contributions during pandemics have received growing attention, including for COVID-19. This paper contributes to learning about CHWs' experiences during COVID-19, based on evidence from India, Bangladesh, Pakistan, Sierra Leone, Kenya and Ethiopia. The paper synthesises evidence from a set of research projects undertaken over 2020-2021. A thematic framework based on the research focus and related literature was used to code material from the reports. Following further analysis, interpretations were verified with the original research teams. CHWs made important contributions to the COVID-19 response, including in surveillance, community education, and support for people with COVID-19. There was some support for CHWs' work, including training, personal protective equipment and financial incentives. However, support varied between countries, cadres and individual CHWs, and there were significant gaps, leaving CHWs vulnerable to infection and stress. CHWs also faced a range of other challenges, including health system issues such as disrupted medical supply chains, insufficient staff and high workloads, a particular difficulty for female CHWs who were balancing domestic responsibilities. Their work was also affected by COVID-19 public health measures, such as restrictions on gatherings and travel; and by supply-side constraints related to community access and attitudes, including distrust and stigmatization of CHWs as infectious or informers. CHWs demonstrated commitment in adapting their work, for example ensuring patients had adequate drugs in advance of lockdowns, and using their own money and time to address increased transport costs and higher workloads. Effectiveness of these adaptations varied, and some involved coping in a context of inadequate support. CHW are critical for effective response to disease outbreaks, including pandemics like COVID-19. To support CHWs' contribution and protect their wellbeing, CHWs need adequate resources, managerial support, and motivation.

Tissue specific changes of phytochemicals, antioxidant, antidiabetic and anti-inflammatory activities of tea [Camellia sinensis (L.)] extracted with different solvents.

Different parts of Camellia sinensis (L.) were extracted with solvents according to polarity, and the extracts' phytochemical profiling and biological activities were examined. The total phenolic (TPC) and total flavonoid (TFC) contents increased with the increasing polarity of the solvent which met its maximum in polar solvents. The increasing antioxidant, anti-inflammatory and antidiabetic activities were recorded with increasing polarity of solvents which showed hydroalcoholic as best solvent. The strong and significant correlation was among the TPC, TFC, DPPH, anti-inflammatory and antidiabetic activities for different parts of tea. HPTLC study of individual phenolic acids, epigallocatechin gallate, gallocatechin and theaflavin met their maximum level of content with polar solvents like hydroalcohol, methanol and water mostly in mainly tea leaves. Our finding suggested that the polar solvents and young leaves of tea were beneficial for obtaining extracts. On the other hand, phenolics were found to be potent antioxidant, anti-inflammatory and antidiabetic agent.

Effects of COVID-19 on STEMI Patients: Single-Center Experience.

Aim: The purpose of this study is to assess the effect of the COVID-19 pandemic on the volume of ST-elevation myocardial infarction (STEMI) patients and also to assess changes in patient characteristics, door-in-to-door-out (DIDO) time, door-to-balloon time (D2B) time, and STEMI outcomes during the pandemic. Methods: Patient data were retrieved retrospectively from the electronic medical record system of King Hamad University Hospital and Mohammed Bin Khalifa Cardiac Centre in the Kingdom of Bahrain. Data were compared and analyzed for the two time periods: before the pandemic (January 2019-March 2020) and during the pandemic (April 2020June 2021). Results: There was a decline of 11.1% in patients who presented with STEMI during the pandemic. There were no major differences between the patient demographics and the baseline characteristics during the two study periods. Recommended DIDO time and D2B time could be achieved only for 7.1% and 35.7% of all STEMI cases during the pandemic. However, no significant differences were noted in the 30 days of mortality, reinfarction, cardiogenic shock, hospital length of stay, and return to the hospital within 30 days for the STEMI patients in the two time periods. Conclusions: There was a decline in patients who presented with STEMI during the pandemic. This was also associated with a lower number of STEMI cases achieving the recommended DIDO time and D2B time as compared to the prepandemic period. However, there was no significant difference in the patient outcomes in the two time periods.

Women's contribution to medicine in Bahrain: leadership and workforce.

BACKGROUND: Women make up a significant proportion of workforce in healthcare. However, they remain underrepresented in leadership positions relating to healthcare for a multitude of reasons: balancing personal and work duties, favoritism toward men, lack of support from colleagues and mentors, as well as other factors. This study aims to recognize the contribution made by women in the Bahraini healthcare sector by determining the gender distribution in Bahrain's medical schools, government hospitals, Ministry of Health, and National Health Regulatory Authority. METHODS: Data were collected from the Bahraini Ministry of Health, National Health Regulatory Authority, Salmaniya Medical Complex, King Hamad University Hospital, Bahrain Defence Force Royal Medical Services, the College of Medicine and Medical Sciences in the Arabian Gulf University, and the Royal College of Surgeons in Ireland-Bahrain. Only physicians who held a Bachelor of Medicine and Surgery and a valid license to practice from NHRA were eligible to participate. Descriptive statistics were used to derive the frequencies and percentages of physicians with the following leadership positions: (1) top administrative positions (e.g., Chief executive officer); (2) heads of departments; (3) heads of committees; and (4) academic positions (e.g., Professor). Data were also collected from the two medical schools in Bahrain to see the trend in female enrollment into medical schools since 2004. RESULTS: The results of the study indicated that leadership positions were mostly held by males in Bahrain (59.4% vs. 40.6%). However, Bahraini males and females equally dominated academic positions. Male physicians also dominated surgical specialties; however, female Bahraini physicians slightly surpassed male Bahraini physicians at the specialist and consultant levels (female to male: 11.9% vs. 10.4% and 33.2% vs. 30.4%, respectively). Furthermore, more females were reported to have general licenses. A trend analysis since 2004 showed that female medical students' representation was higher than males over the years. CONCLUSIONS: This study highlights the increasing trend of women's participation and contribution to medicine in Bahrain. The data indicated continued growth in the number of female medical students and physicians. As such, it is likely that females will have a bigger impact on healthcare in the future with potential to hold more leadership positions in Bahrain.

Theoretical investigation of a tetrazine based covalent organic framework as a promising anode material for sodium/calcium ion batteries.

Nowadays, great attention is being directed towards the development of promising electrode materials for non-lithium rechargeable batteries such as sodium and calcium ion batteries (SIBs and CIBs), due to their large abundance, storage capacity and charge/discharge rate. Using density functional theory (DFT) based computations we have predicted that the recently synthesized bilayer s-tetrazine based covalent organic framework (bilayer TZACOF) may be a promising anode material for sodium and calcium ion batteries. The electronic band structure calculations suggest that the bilayer TZACOF is an indirect band gap semiconductor with a band gap of 0.95 eV. The sodium and calcium atoms are adsorbed on the bilayer TZACOF at the most energetically favorable adsorption sites with adsorption energies of -1.37 eV and -2.27 eV, respectively. Moreover, the diffusion energy barriers for the migration of sodium and calcium atoms on the bilayer TZACOF are 0.19 eV and 0.63 eV, respectively, which indicates the fast ion mobility and charge/discharge rate. The theoretical specific capacity (TSC) of the bilayer TZACOF as the electrode material for SIBs and CIBs is 618.69 and 412.46 mA h g-1, respectively. Furthermore, the average voltage of the bilayer TZACOF as the electrode material for SIBs and CIBs is found to be 0.96 and 1.13 V, respectively. Based on the results of rich electronic properties, low diffusion barriers, high storage capacity, and low average voltage, we can reach at the conclusion that the bilayer TZACOF may be a suitable candidate for use as an anode material for sodium and calcium ion batteries (SIBs and CIBs).